Blood draws and Starting IVs

emnicams · Dec 17, 2008

We didn't do blood draws in nsg school. We don't do them in the hospital either, it's a large hospital so we have phlebotomists.

As far as IV's... I had the opportunity to practice this skill twice in nsg school. I have been an RN for almost a year and I'm just now really getting the hang of it. Just practice, practice, practice. If I'm having a good day, I will ask my coworkers if they have any IV restarts due, or to let me know if they have one infiltrate, etc. I also spent half a day with the MRT guy who we call if we have a difficult stick or are too busy and need an IV stat. He showed me a lot of tricks and tips and I have been much better at starting IV's since.

It all comes with practice and experience.

Virgo_RN, BSN, RN · Dec 17, 2008

I will be graduating in May 09 and have only done one or two blood draws and I've never started an IV. Do nurses not do this in the field the reason its not emphasized? Does anyone have any advice on blood draws or starting an IV? ( i.e. equipment needed, procedures, dos and don'ts)

I am expected to start IVs, but we have phlebotomists at our hospital that do all the blood draws, except for those from central lines. The nurses do that.

classicdame, MSN, EdD · Dec 17, 2008

there is no way you can become confident in all nursing skills while in school. You really have to practice. When we hire new grads we place them in Same Day Surgery to get IV experience with preceptors. By the end of a few days they are expert!

Hands&Feet · Dec 18, 2008

We were told that we are not allowed to start IVs as students due to the risk of liability. :sniff: They said that once we were hired, the agency would train us on the procedure. Not sure about blood draws, though.

lpnstudentin2010, LPN · Dec 18, 2008

......And some folks are just plain hard sticks.

ME ME ME ME. Some advice I would give you as a patient.

1. put paper towel between the terniquet and the person, it makes it hurt less

2. if someone tells you they are a hard stick, believe them. I am a hard stick, the last 2 times I have needed an IV they have needed to go in my FOOT due to a lack of veins to be used.

nghtfltguy, BSN, RN · Dec 18, 2008

ok... i will tell you how it is...

as most have told you here already... you don't get the chance to do it that much in school... *depending on your school*

you will have to start IV's more so than other places depending on where you work...

for instance...

if you work in a LTC... you might start 1 or 2 every 5 or 6 months if you are lucky...

if you are like me.. and work in an ER... you start 5 for 6 a day... at least!

my advice to you...

if you are not comfortable w/ them.. ask your supervisor if you can go to ambulatory surgery.. or the pain clinic... or the ER.. somewhere that starts them all the time just to get some practice...

99% of the time ... the nurse managers in those departments are willing to take you on and let you get the practice...

i'll tell ya the biggest thing that i see.... on ppl that can't get them..

if you can find a good vein and palpate it... or visualize it... then what you need to do is *anchor* it... hold it down distally and pull back a bit to keep it in place....

you always hear of so many ppl saying...* oh.. it rolled on me* or something like that...

well... im gonna tell ya...

if you anchor it and hold on to it.... you can hit it!!

it just takes time and practice... there are no such things as *rolling veins*... all veins will if ya don't anchor em right!...

find your spot... put your thumb below it and pull down and push it at the same time w/ your thumb to anchor it.....

it will keep it in place....

my most important advice though~~~

practice makes perfect...

everyone is bound to miss an iv now and then... don't feel bad about it..

:cool:

Tim92 · Dec 18, 2008

I don't mine starting IV's, but I am not sure if nursing schools do too much of that. Also, I think in nursing schools are not allowed to draw blood because of AIDS and things like that, i'm not 100% sure though.

DebanamRN, MSN, RN · Dec 18, 2008

On my first attempt at starting an IV, the patient yelled and I ran out of the room. The RN who was with me did the IV. Now, after nearly 1 1/2 yrs in the ER, I have the nickname "Vampire Lady." I'm pretty good and get better all the time.

Some things I do:

Hang the arm down - let gravity help.

Ask the patient were they get their blood drawn. They will tell you.

Listen to patients. They know were their veins are better than you do.

Don't look. Feel for the "bounce."

Know your anatomy. This helps a lot.

I've drawn from a foot and inserted an IV into a thumb. Yuk!

I also went to ACLS and PALS and learned to insert a line in bone. The more confident you become, the more you will want to learn.

Lastly, I followed around every nurse and tech I knew was really good at blood and IV's. Watch them, and you will learn and be ok.

Deb:wink2:

blondy2061h, MSN, RN · Dec 18, 2008

2. if someone tells you they are a hard stick, believe them. I am a hard stick, the last 2 times I have needed an IV they have needed to go in my FOOT due to a lack of veins to be used.

But EVERYONE thinks they're a hard stick. Clearly, you truly are.

untamable07 · Dec 18, 2008

Ok thanks for all your advice. I guess I'm worried because I work as an extern on L&D and want to work there when I graduate and the nurses do their own blood draws and IVs. I'm not sure if they will let me practice their as a student extern since I work there also. I guess I will just have to ask.

jallen5 · Dec 18, 2008

The things that I am the most terrified of in nursing school are:

1. Practicing blood draws and IVs on fellow students.

2. Not being confident about doing them in practice.

3. The part of health assessment class where a peer is going to see my horrible stretch-mark belly.

I have nightmares about these things. I hope I can get over these before they become such a mental block that I can't let go when the time comes to do them.